Three‐dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women

Ni, Jia Yan; Han, Bingbing; Liang, Jinqian; Wang, Fang

doi:10.1002/ijgo.12787

Cited by 15 publications

(12 citation statements)

References 20 publications

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“…The fact of heterogeneity of the endometrial structure as one of the main features of chronic endometritis (it was established by us in most of the examined patients of the main group) is repeatedly confirmed in the works of other authors [15,18].…”

Section: Discussionsupporting

confidence: 64%

Anatomo-functional characteristics of the pelvic organs in women with habitual miscarriage and chronic endometritis

et al. 2020

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Chronic endometritis is a clinical and morphological syndrome, which under the influence of an infectious agent contributes to the violation of cyclic biotransformation and reciprocity of the endometrium. In the diagnosis of gynecological pathology, in particular chronic endometritis, or habitual miscarriage on the background of chronic endometritis, ultrasonography is a mandatory, non-invasive and highly specific method of research. The aim of the study was to assess the anatomical and functional condition of the pelvic organs in women with habitual miscarriage and chronic endometritis using ultrasound (ultrasound and Doppler) criteria. We examined 98 women of childbearing age who applied to the Inomed clinic in the city of Vinnytsia during 2019-2020. Patients were divided into two groups: the main group – 68 women with habitual miscarriage and chronic endometritis; control group – 30 re-pregnant women without previous pregnancy loss. Initially, ultrasound examination (ultrasound) of the pelvic organs was performed on day 5-7 of the menstrual cycle, and to monitor folliculogenesis, the study was repeated on day 13-17 of the cycle. One of the main signs of chronic endometritis is the heterogeneity of the structure of the endometrium, which was found in the vast majority of examined patients of the main group (80.88% at n=68). When determining the thickness of the endometrium, two diametrically opposite processes were established, namely: atrophy (39.71% at n=68) and atypical glandular hyperplasia (22.05% at n=68). In the second half of the menstrual cycle there was a significant thinning of the endometrial layer <0.6 cm. In the control group during the ultrasound examination revealed the following disorders: increased uterine peristalsis, dilation of the arcuate plexus, the heterogeneity of the subendometrial layer, and when re-ultrasound took into account the data of folliculogenesis. Follicular cysts were detected in 10.3% of cases in the main group and 3.3% in the control group of women. At the time of re-ultrasound in each ovary was observed 5-8 antral follicles (the size of which ranged from 6.8 mm to 11.5 mm) with the presence of one dominant, the size of which ranged from 18.2 to 23.4 mm. In order to increase the informativeness of ultrasound, Doppler was additionally performed. Thus, ultrasonography is a highly specific method for determining the anatomical and functional characteristics of the pelvic organs, in particular the pathology of the endometrium in women with habitual miscarriage. The main ultrasound characteristics of chronic endometritis, as one of the causes of reproductive losses, are changes in endometrium structure, thickness, the presence of additional structures (polyps) and fluid component. Informativeness of ultrasound examination of structural changes in the endometrium in chronic endometritis is complemented by Doppler characteristics of blood flow in the basal and spiral arteries of the uterus.

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Section: Discussionsupporting

confidence: 64%

Anatomo-functional characteristics of the pelvic organs in women with habitual miscarriage and chronic endometritis

et al. 2020

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“…For PG, the ploughing technique allowed the myometrium blood supply to spread upwards to the endometrium and improved endometrium blood flow (15). Endometrial volume and blood flow parameters remained consistent, which was known to be important for embryo invasion and placentation (27). Furthermore, removing uterine contracture by scar ploughing could increase uterine cavity volume and promote endometrium restoration, which benefited implantation along with the growth and development of fertilized ova.…”

Section: Discussionmentioning

confidence: 99%

Cold scissors ploughing technique in hysteroscopic adhesiolysis: a comparative study

et al. 2020

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Background: Intrauterine adhesions (IUAs) can be dissected using hysteroscopic scissors (cold scissors) or other methods, but there is no consensus on which hysteroscopic method is preferable. There is also no consensus on the method of how to deal with the scar tissue on the surface of the intrauterine cavity.Methods: From January 2016 to October 2017, 179 patients who had HA met the enrollment criteria (see the text below), and their data were analyzed retrospectively. In addition, all patients were divided into three groups according to the surgical techniques used. The groups were the ploughing group (PG) (using cold scissors to dissect the adhesion and cut the scar tissue using a ploughing technique) (n=81), the traditional group (TG) (using cold scissors to dissect the adhesion, but not deal with the scar tissue) (n=42), and the electrosurgical group (EG) (using a resectoscope to dissect the adhesion with an energy L-hook electrode, and not deal with the scar tissue) (n=56). Safety (surgical complications), feasibility (surgical technique replacement rate), and postoperative efficacy (reduction of AFS score, pregnancy, and live birth rate), were each evaluated between groups.Results: No statistically significant differences between the groups were observed in basic preoperative information (P>0.05), while there were significant differences between PG and TG, as well as PG and EG in postoperative AFS scores (PG vs. TG: P=0.007; PG vs. EG: P<0.001) and pregnancy outcome (PG vs. TG: P=0.039; PG vs. EG: P<0.001). No patients had surgical complications such as uterine perforations, moderate or severe fluid overload, heavy uterine bleeding, nor any surgical technique replacements (for example, transfer to use a resectoscope).Conclusions: Cold scissors ploughing technique in HA is effective, feasible, and safe, and thus worthy of further study.

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“…A 3D TVS combined with Power Doppler also has value for the differential diagnosis of endometrial lesions among infertile women. Endometrial thickness and volume were larger among women with endometrial polyps and hyperplasia, whereas endometrial vascularization index, flow index, and vascularization flow index were lower among women with intrauterine adhesions [11].…”

Section: Ultrasound Assessment Of the Uterine Cavitymentioning

confidence: 86%

A comprehensive use of ultrasound examination in infertility workup

Kowalczyk

Klimek

et al. 2021

Ginekol Pol

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show abstract

Three‐dimensional 3D ultrasound combined with power Doppler for the differential diagnosis of endometrial lesions among infertile women

Cited by 15 publications

References 20 publications

Anatomo-functional characteristics of the pelvic organs in women with habitual miscarriage and chronic endometritis

Anatomo-functional characteristics of the pelvic organs in women with habitual miscarriage and chronic endometritis

Cold scissors ploughing technique in hysteroscopic adhesiolysis: a comparative study

A comprehensive use of ultrasound examination in infertility workup

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